The Therapist’s Most Important Tool

Salvador Minuchin on What Today’s Training Approaches Are Missing

By Mary Sykes Wylie

Psychotherapy trainees today are buried beneath textbooks on theory, bombarded by lectures on current research, and taught to be experts in a variety of therapeutic methods. But where and when do they learn who they are and how to use their own selves in therapy?

At 92 years old, Salvador Minuchin, the world’s most famous living family therapy pioneer and probably the most imitated clinical practitioner ever, is still too young for retirement. Now, nearly 50 years after helping foment a revolution in psychotherapy and becoming himself an icon and an institution, the old lion is back in the arena, and with the publication of his latest book, The Craft of Family Therapy, he’s once again challenging the therapeutic status quo.

During the mid-1950s, when Minuchin first began his psychiatric career, almost all therapists followed the psychoanalytic rule book. The goal was to bring to light the individual intrapsychic conflicts from which the patient’s life problems were thought to originate. Because truly meaningful change was thought to emerge only from within the patient’s mind—carefully cultivated and encouraged, but never imposed from without—the therapist wasn’t supposed to get in the way. Well-trained clinicians were expected to embody a kind of divinely empty blank screen, maintaining a posture of reticence and neutrality, so as not to interfere with the workings of the holy transference: the patient’s subconsciously generated projections onto the therapist of emotionally important figures from his or her deep past. How, it was argued, could the patient see and relate to the therapist as his mean father, her overprotective mother, his seductive older sister—thus revealing the source and lineaments of his psychic distress—if the therapist kept butting in with questions, remarks, opinions, observations, encouragements, or, God forbid, emanations of his or her own personality?

Minuchin and the other family therapy pioneers didn’t merely inject a bit of fresh air into this hothouse: they blew the roof right off, taking all the furniture and psychoanalytic tomes along with it. Not only was the focus of their new therapy different, but so was their view of the therapist. No longer the self-contained cipher, sitting mostly silent and sometimes invisible behind the patient’s head, this new kind of therapist—dazzlingly exemplified by Minuchin himself—was brash, interventionist, bossy, and frequently in clients’ faces. In fact, the therapist’s personality—the “self of the therapist,” as it eventually came to be called—was considered a key player in the sometimes rowdy goings on in session. Who the therapist was and how she showed herself in therapy, the way she’d related to her own family of origin, her personality, and, most of all, her use of her specific, personal self in therapy was vital to the success of the whole therapeutic transaction.

After being trained as a psychiatrist, Minuchin went on the usual pilgrimage to New York City—Psychoanalysis Central in those days—to learn the tricks of the analytic trade. But psychoanalysis wasn’t a good fit for a gregarious, assertive, curious, extroverted Argentine Jew, who simply wasn’t cut out for the muted, self-suppressing work of listening silently to people verbally meander through their lives and psyches. Bored and dissatisfied, he leapt at an opportunity to work as a psychiatrist at a residential institution for inner-city delinquents, a school called Wyltwyck.

The experience changed his life. The tough, ghetto-raised black kids at Wyltwyck were no more cut out for psychoanalysis than Minuchin was, though for different reasons. They were nothing like the quiet, cooperative, verbally skilled, and introspective middle-class patients most analysts saw. And analytic therapy was useless for them: after months of in-patient treatment, they’d fall back into trouble soon after returning home. As much from desperation as anything else, Minuchin and his colleagues decided they might as well take a look at how these kids acted with their families. After reading an article or two from other far-flung embryonic family systems theorists, they punched a hole in the wall, installed a one-way mirror, and started watching families in vivo.

It was a revelation. They saw immediately that focusing on the “individual motivation” and “intrapsychic processes” of any one family member was beside the point: all the action, all the life, all the juicy emotional “processes” happened between people. The way family members behaved, the feelings they expressed—the yelling, the crying, the stomping around, the fist-shaking, the interrupting—didn’t seem to emerge de novo from deep within any one psyche, but in obvious response to the behaviors and expressed feelings of the others. Back and forth and up and down the personal interactions went, in complex, intermingling feedback loops.

Early on, these innovators instructed people to talk to each other, rather than to the therapist, and these “conversations”—staged and kept more or less orderly by the therapist referee—became the basis of “enactments,” which revealed the family’s entrenched emotional patterns better than any spelunking into the deep psychic caves of the individual participants. Through all of this, the therapist was an active participant. “The idea was to help the dancers dance, and the therapist would be the one leading the do-si-do,” Minuchin recalled later.

To this day, Minuchin’s style, caught in classic videos as entertaining as they are instructive, represents the embodiment of the antianalyst: energetic, active, expressive, now here, now there, now everywhere at once, and anything but retiring—except when retiring, or strategically “stepping back,” becomes itself an active intervention. Minuchin himself is often mesmerizing: he mocks, reassures, flatters, cajoles, charms, needles, encourages, congratulates, and confronts the families he sees. Sometimes, when the family seems terminally stuck in its own roundabout, he looks bored, as if he is mentally checking his watch. At other times, he makes jokes, interrupts, orders people around, touches them, gives them short lectures—all in an Argentine accent that probably thousands of Minuchin wannabes have unconsciously mimicked. These performances (Minuchin has been compared often to a stage director or impresario) are indeed entertaining, funny, serious, and often moving.

2 comments

I was trained by the masters who started the family therapy movement and I appreciate the recounting of how we family therapists viewed our craft. I too am concerned that the students or interns I encounter are so focused on methodology versus an understanding of the family and their interaction with them as a means for change. I am glad that Sal is still with us and holding the mirror for us to see ourselves.

This is the kind of "therapist" I'm talking about! This man is exactly the type of counselor/therapist society needs to kick people into gear and into reality. No more sitting back, scratching notes and scratching your head while your client speaks and cries, wondering what the hell your writing and why aren't you paying attention. This is what people want and need, a REAL person to talk to and to get feedback from. Why don't the "professionals" get that? Take off your suits & ties and get out from behind that pretty desk, put on your regular clothes and sit on the floor or a chair with your client and just BE REAL!